The prevalence of osteoporosis in India ranges between eight and 62% in women of different ages, based on several studies. In simple terms, osteoporosis means weak and brittle bones, commonly seen in post-menopausal women. In this condition, they are at an increased risk of fractures even by minor trauma, leading to significant morbidity and even mortality. We spoke to Dr I. Rajendra Vara Prasad, Consultant Rheumatologist, Yashoda Hospitals, Hyderabad, to learn more about this. In this article, he explains steps to prevent osteoporosis in women.
Risk Factors Of Osteoporosis In Women
Estrogen deficiency is the primary cause of post-menopausal women developing osteoporosis. Other important risk factors that lead to osteoporosis in women are advanced age, genetics, smoking, a lean body, and many diseases and drugs that impair bone health. Urbanisation is a risk factor because of the dominant sedentary lifestyle and indoor living with poor sun exposure.
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Bones form a vital part of our body, constantly renewing until the age of 30 and gradually weakening at varying paces later on. Many factors affect bone growth: genes, gender, ethnicity, body mass index, maternal body build, growth around adolescence, bone surface area, peak bone mass, physical activity, sun exposure, vitamin D and K, calcium and protein intake.
Osteoporosis almost always results in a fragility fracture, and often, it is the only event that forces us to visit hospitals. Who will go to seek advice for an unforeseen complication of a silent disease? Even if one does visit the hospital, assessment of osteoporosis is not prioritised because often, there is another pressing which needs attention in that scenario. So it is often underdiagnosed and untreated. Thus prevention is essential to averse the risk of osteoporosis.
Prevention of Osteoporosis in Women
Dr Prasad suggested to women the following measures to prevent osteoporosis.
Follow a Calcium & Protein-Rich Diet
A healthy, nutrient-rich, balanced diet is essential for strong bones. Adequate protein and calcium in the diet are vital for bone health. You should include sources rich in calcium, including dairy products (which have better bioavailability), green leafy vegetables, and fortified foods.
“Indian traditional diets often fall short of the 600 mg daily minimum that the Indian Council of Medical Research recommends. This is because they are predominantly vegetarian with low calcium intake from dairy products. The gender discrepancy, where boys and men are given a larger share of food and milk, plays its part. Our diets have a higher ratio of phytates (whole grains, seeds, legumes and some nuts) to calcium, especially among rural Indians, which hinders calcium absorption. So particular care to overcome these shortcomings and actively including calcium and protein-rich food in diets of especially at-risk women will benefit many women." added Dr Prasad.
Intake Of Adequate Vitamin D
Vitamin D is essential for calcium absorption, thereby, in bone health. It is synthesised in our skin upon exposure to sunlight. Though we have enough sunlight in India, various studies have indicated that deficiency of vitamin D is prevalent almost globally. The reasons could be a predominant indoor lifestyle, traditional clothing decreasing sun-exposed skin, inadequate intake, poor vitamin D fortification of foods, skin pigmentation, and atmospheric pollution.
Women should aim for 600 to 800 international units of vitamin D per day, which can be obtained from adequate sun exposure, including fatty fish and fortified foods in their diet, especially those at risk of osteoporosis.
Also Read: Bone Density Test For Osteoporosis: Know What It Is & When You Should Opt For It
Exercise Regularly
Muscle mass and bone strength go hand in hand, so exercises will help maintain muscle mass and bone strength and delay or prevent osteoporosis. Women should work to optimise their body mass index.
Physically inactive post-menopausal women should take up an active lifestyle, while those already osteoporotic should exercise regularly. Exercise helps not only in restoring muscle strength but also in maintaining balance and posture, improving confidence and reaction times.
Women should practice a combination of exercise programmes, including weight-bearing and resistance-strengthening exercises. Weight-bearing exercises such as jogging, walking, and weightlifting can help maintain bone density.
Also Read: Stages of Osteoporosis: Signs of Early and Late Stage Osteoporosis
It is also essential to avoid certain postures involving repetitive forward bending, which may be associated with an increased risk of new vertebral fractures, especially in women with osteoporosis.
Fall prevention is the most important and often neglected simple step in preventive measures. Using low-heeled footwear with rubber soles for better grip, avoiding slippery floors, and home safety interventions like using handrails for stairs, adequate light in risk areas, and support bars in the bathrooms are very helpful in preventing falls leading to fractures. Many hesitate to use walking aids which are proven in order to avoid fractures. In this regard, educating people about the same becomes essential.
Other Lifestyle Measures
Everyone should seek an active and healthy lifestyle. Cigarette smoking and alcohol consumption increase the risk for osteoporosis, which are worth mentioning here, though they are not significant factors in our country. Diabetes is a common problem in India, and people who suffer from it should also take all precautions since it also can lead to weak bones.
Medication Abuse
Steroid abuse is common in women with joint problems like rheumatoid arthritis. And over the counter long-term steroid abuse is one of the causes of osteoporosis apart from the disease itself, which should be avoided.
Post-menopausal women and women who undergo hysterectomies are at risk of osteoporosis and should know about bone health and take preventive measures. Women above 65 should seek a doctor's advice to assess bone strength, especially when there is a history of fractures in their parents or siblings. By following these steps, women can reduce their risk of osteoporosis and maintain strong and healthy bones.
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